Register your account

Please, click on the appropriate icon for your professional statusto begin the Starz Tipz registration process.

DEAR DENTAL PROFESSIONAL,THANK YOU FOR INTEREST IN STARZ TIPZ

As a registered dental professional, you will be able to purchase direct, track your ordering history, enroll and track your rewards, and take advantage of special purchase opportunities offered only to our preferred doctors, hygienists and staff. You will also be able to access important information about Starz Tipz and your equipment.

Also, at your request, we can contact your distributor to let them know you want them to
carry our product(s). Other information helps us know more about your probable
purchasing patterns and will help us help you NEVER run out of Starz Tipz.

Please fill out the form below and click on the submit button when you are finished.

* indicates required field.

DEAR AFFILIATE,THANK YOU FOR REGISTERING WITH US

As an affiliate, or independent representative of dental products, you are a valuable
asset for us and we will reward you with outstanding commissions and incentives when you become a Starz Tipz Affiliate Rep.

Please fill out the form below and click on the submit button when you are finished.

* indicates required field.

DEAR TECHNICIAN AFFILIATE,THANK YOU FOR REGISTERING WITH US

As an technician affiliate, or independent representative of dental products, you are a valuable asset for us and we will reward you with outstanding commissions and incentives when you become a Starz Tipz Technician Affiliate.

Please fill out the form below and click on the submit button when you are finished.

* indicates required field.

DEAR DISTRIBUTOR,THANK YOU FOR REGISTERING WITH US

To become an authorized Starz Tipz Distributor, please fill out the form below.

Please fill out the form below and click on the submit button when you are finished.

* indicates required field.

DEAR DISTRIBUTOR REP,THANK YOU FOR REGISTERING WITH US

To become an authorized Starz Tipz Distributor, please fill out the form below.

PLEASE CREATE YOUR LOGIN CREDENTIALS

USERNAME*

PASSWORD*

PLEASE RE-TYPE YOUR PASSWORD*

PRIVACY POLICY

We recommend your password be at least 5 characters. It should be different from you username. Your email must be valid. We use email for communication purposes (order notifications, etc.). Therefore, it is essential to provide a valid email address to be able to use our services correctly. All your private data is confidential. We will never sell, exchange or market it in any way. For futher information on responsibilities of both parties, please refer to our Terms & Conditions.

Click here to accept our Terms & Conditions

FIRST NAME*

LAST NAME*

COMPANY NAME*

PRIMARY CONTACT*

PHONE NUMBER*

SECONDARY CONTACT

PHONE NUMBER

FAX NUMBER

EMAIL ADDRESS*

ADDRESS*

UNIT NO. (If Applicable)

CITY*

COUNTRY*

STATE*

ZIP CODE*

OTHER INFORMATION

TERRITORY YOU COVER

COUNTRIES YOU COVER

DISTRIBUTORS/DEALERS YOU CURRENTLY WORK DIRECTLY WITH

FIRST COMPANY

SECOND COMPANY

THIRD COMPANY

LIST TOP 5 DENTAL PRODUCTS YOU REPRESENT

DO YOU CURRENTLY REPRESENT A DISPOSABLE SYRINGE TIP?

Yes
No

Sani-Tip®
Seal-Tight®
Safe-Tip Ez®

RisKontrol®
Pro-Tip®
Metal Tip

Spree®
FlashTips®
Other Tips

HAVE YOU EVER PREVIOUSLY REPRESENTED A DISPOSABLE SYRINGE TIP?
Yes
No

PLEASE CREATE YOUR LOGIN CREDENTIALS

USERNAME*

PASSWORD*

PLEASE RE-TYPE YOUR PASSWORD*

PRIVACY POLICY

We recommend your password be at least 5 characters. It should be different from you username. Your email must be valid. We use email for communication purposes (order notifications, etc.). Therefore, it is essential to provide a valid email address to be able to use our services correctly. All your private data is confidential. We will never sell, exchange or market it in any way. For futher information on responsibilities of both parties, please refer to our Terms & Conditions.

Click here to accept our Terms & Conditions

FIRST NAME*

LAST NAME*

COMPANY NAME*

PRIMARY CONTACT*

PHONE NUMBER*

SECONDARY CONTACT

PHONE NUMBER

FAX NUMBER

EMAIL ADDRESS*

ADDRESS*

UNIT NO. (If Applicable)

CITY*

COUNTRY*

STATE*

ZIP CODE*

OTHER INFORMATION

TERRITORY YOU COVER

COUNTRIES YOU COVER

DISTRIBUTORS/DEALERS YOU CURRENTLY WORK DIRECTLY WITH

FIRST COMPANY

SECOND COMPANY

THIRD COMPANY

DO YOU CURRENTLY WORK WITH DENTAL CHAIR MANUFACTURERS?

HOW DID YOU HEAR ABOUT STARZ TIPZ®?

DO YOU CURRENTLY REPRESENT A DISPOSABLE SYRINGE TIP?

Yes
No

Sani-Tip®
Seal-Tight®
Safe-Tip Ez®

RisKontrol®
Pro-Tip®
Metal Tip

Spree®
FlashTips®
Other Tips

HAVE YOU EVER PREVIOUSLY REPRESENTED A DISPOSABLE SYRINGE TIP?
Yes
No

PLEASE CREATE YOUR LOGIN CREDENTIALS

USERNAME*

PASSWORD*

PLEASE RE-TYPE YOUR PASSWORD*

PRIVACY POLICY

We recommend your password be at least 5 characters. It should be different from you username. Your email must be valid. We use email for communication purposes (order notifications, etc.). Therefore, it is essential to provide a valid email address to be able to use our services correctly. All your private data is confidential. We will never sell, exchange or market it in any way. For futher information on responsibilities of both parties, please refer to our Terms & Conditions.

Click here to accept our Terms & Conditions

FIRST NAME*

LAST NAME*

NAME OF DISTRIBUTOR*

DISTRIBUTOR ADDRESS*

UNIT NO. (If Applicable)

CITY*

COUNTRY*

STATE*

ZIP CODE*

PRIMARY CONTACT*

FAX NUMBER

EMAIL ADDRESS*

SECONDARY CONTACT

SHIPPING ADDRESS (Only if different from mailing address)

ADDRESS

CITY

STATE

ZIP CODE

COUNTRY

ACCOUNTING DEPARTAMENT CONTACT*

FAX NUMBER*

EMAIL ADDRESS*

OTHER INFORMATION

NO. OF SALES REPRESENTATIVES

I AM A NATIONAL DISTRIBUTOR
Yes
No

PLEASE LIST DISTRIBUTION CENTER LOCATIONS BY STATE

I AM A REGIONAL DISTRIBUTOR
Yes
No

I AM A LOCAL DISTRIBUTOR
Yes
No

COUNTRIES YOU COVER

TOP 3 DISPOSABLE SYRINGE TIPS YOU SELL

PLEASE CREATE YOUR LOGIN CREDENTIALS

USERNAME*

PASSWORD*

PLEASE RE-TYPE YOUR PASSWORD*

PRIVACY POLICY

We recommend your password be at least 5 characters. It should be different from you username. Your email must be valid. We use email for communication purposes (order notifications, etc.). Therefore, it is essential to provide a valid email address to be able to use our services correctly. All your private data is confidential. We will never sell, exchange or market it in any way. For futher information on responsibilities of both parties, please refer to our Terms & Conditions.

Click here to accept our Terms & Conditions

FIRST NAME*

LAST NAME*

NAME OF DISTRIBUTOR*

DISTRIBUTOR ADDRESS*

UNIT NO. (If Applicable)

CITY*

COUNTRY*

STATE*

ZIP CODE*

YOUR PHONE NUMBER*

FAX NUMBER

EMAIL ADDRESS*

SHIPPING ADDRESS (Only if different from mailing address)

ADDRESS

CITY

STATE

ZIP CODE

COUNTRY

OTHER INFORMATION

STATE(S) YOU COVER

COUNTRIES YOU COVER

NO. OF DENTAL OFFICES YOU CALL ON

TOP 3 DISPOSABLE SYRINGE TIPS YOU SELL

PLEASE CREATE YOUR LOGIN CREDENTIALS

USERNAME*

PASSWORD*

PLEASE RE-TYPE YOUR PASSWORD*

PRIVACY POLICY

We recommend your password be at least 5 characters. It should be different from you username. Your email must be valid. We use email for communication purposes (order notifications, etc.). Therefore, it is essential to provide a valid email address to be able to use our services correctly. All your private data is confidential. We will never sell, exchange or market it in any way. For futher information on responsibilities of both parties, please refer to our Terms & Conditions.

Click here to accept our Terms & Conditions

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Rewards

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